Intrahepatic sarcomatoid cholangiocarcinoma with portal vein thrombus misdiagnosed as hepatocellular carcinoma: description of a rare case

Abstract

Less than 1% of malignant tumors of the hepatobiliary system are intrahepatic sarcomatoid cholangiocarcinomas, a rare malignant tumor of the liver. Based only on clinical presentation and imaging, this entity is readily mistaken for hepatocellular carcinoma. In this article, we describe the case of a 36-year-old male patient who had a history of "cirrhosis B" and was hospitalized for six months due to increased alpha-fetoprotein. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a 63x 90 mm mass in segments V and VI of the liver, with thrombosis in the right branch of the portal vein. Following the patient's laparoscopic lobectomy and cholecystectomy, sarcomatoid cholangiocarcinoma of the right side of the liver was discovered by histopathological and immunohistochemical examinations. This case report seeks to increase understanding of intrahepatic sarcomatoid cholangiocarcinoma and its diagnosis while reducing the occurrence of clinical misinterpretation.